Morton Cottage Residential Home

Morton Cottage Residential Home is a 'care home'. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Morton Cottage is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this assessment. The service is registered to support a maximum of 32 people. There were 27 people living at the service at the time of inspection.

We looked at all quality statements in Safe, Effective, Caring, Responsive and Well-Led.

There was a stable, compassionate leadership team and an experienced core of staff. Governance and oversight of systems, safety and processes, still required improvement. Gaps in oversight and analysis of systems and processes meant lessons had not always been learned and necessary improvements had not always been made. Safeguarding incidents were reacted to make people safe in the moment, but notifications to external bodies, and meaningful analysis, had not always been effective.

Medicines management had been improved. The provider had made some environmental improvements, but there was ongoing work to be done. The age and layout of the building was a challenge. Cleaning staff did well to maintain good standards of cleanliness. The provider needed to ensure the environment, inside and out, was more suitable for people living with a dementia.

The registered manager recognised there was more work to do to ensure records were continually reviewed and improved, and dementia-friendly best practice be considered when refurbishing the outdoor spaces

People interacted warmly with staff, who communicated well with them and each other during our inspection. On occasion, staff missed opportunities to identify how people could be more involved in the running of the service, better informed about day-to-day options, and less anxious.

Leadership arrangements were clearer and much more open. Links between leaders and external professionals was much improved. Audits, which were significantly lacking during our last inspection, were much improved, and helped ensure standards of care were safe.

Care plans and risk assessments contained person-centred detail regarding how to reduce risks. However, the provider had not always ensured risks were understood and managed holistically. Staff worked well with external professionals to review people’s needs and to reduce the risks they faced.

People who used the service, relatives, staff and external professionals felt the culture was one which supported people and their families to receive good quality care.

There were sufficient staff to meet people’s needs safely, including when people’s needs changed. Staff were knowledgeable about their needs and preferences. They demonstrated a sound understanding of the risks faced by people. The provider needed to review and improve recruitment processes, as well as how it formally recorded supportive conversations with staff.

Advanced care planning, including end of life care planning, was in place.

The provider was previously in breach of the legal regulation in relation to good governance. Sufficient improvements were not found at this assessment, and the provider remained in breach of this regulation.

The provider was previously in breach of the legal regulation in relation to safe care and treatment, specifically around risk assessments and testing of equipment and services. Sufficient improvements had been made at this assessment, and the provider was no longer in breach of this regulation.

We have asked the provider for an action plan in response to the concerns found at this assessment.